Atopic Dermatitis: What Happens

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What Happens

Atopic dermatitis causes repeated attacks of itching and rash that can become quite severe. It is most common in babies and children. Older studies indicated that most children outgrow the condition. More recent studies report that many people continue to have relapses or to have the condition, although not as severely, as teenagers and adults.¹ Also, a person may develop atopic dermatitis as an adult.

Infants and children (ages 2 months to 11 years)

• Of children with atopic dermatitis, approximately 50% first develop symptoms in the first year of life and 30% between ages 1 and 5.⁴
• About 80% of children with atopic dermatitis develop asthma or allergic rhinitis later in childhood.⁴
• Infants and children with a food allergy that triggers atopic dermatitis are at higher risk for developing asthma.

Atopic dermatitis may affect how children feel about themselves. A child may feel strange or different from other children because of the rash or restrictions in diet. The rash may make a child feel unattractive.

Adolescents and adults

Teens and adults with a history of atopic dermatitis usually continue to itch and have a rash.

• When atopic dermatitis occurs for the first time in adulthood, it is usually more severe than long-standing atopic dermatitis.
• Although some affected adults have had no skin problems since infancy, others have had attacks of atopic dermatitis throughout childhood.
• Atopic dermatitis in adults can often be related to a change in environment, such as going from a humid environment to a dry environment, or increased exposure to allergens, such as dust mites or animal dander.

Complications

Some people with atopic dermatitis develop patches of lighter skin, especially on the face, upper arms, or shoulders. Chronic scratching or rubbing of the skin can also lighten or darken skin color. When atopic dermatitis has been successfully controlled, it takes about 9 months for skin color to return to normal. The darker the natural skin color, the longer this might take.⁵

Infections caused by bacteria are common. Infected skin may become red and warm, and a fever may develop. Skin infections are treated with antibiotics.

Atopic dermatitis can affect the skin and tissue surrounding the eyes, but these eye problems are rare.

Eczema herpeticum results when atopic dermatitis is infected with the herpes simplex virus, the virus that causes cold sores and genital herpes. In this condition, the rash blisters and may begin to bleed and crust, and you may have a high fever. This is a serious infection—contact your doctor immediately.

Atopic dermatitis and smallpox vaccination

People with skin conditions such as atopic dermatitis have a high risk of developing a severe rash called eczema vaccinatum if they receive the smallpox vaccine or touch another person’s vaccination mark before the scab has fallen off. Although most people recover from eczema vaccinatum, the rash can be quite severe, sometimes leading to death. People who do not have eczema at the time of vaccination but have a history of eczema also are at increased risk of developing eczema vaccinatum.

Last updated:	May 05, 2008
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Martin Gabica, MD - Family Medicine, Anne C. Poinier, MD - Internal Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC